Minister for Mental Health and Older People publishes the third progress report on the implementation of the recommendations of the COVID-19 Nursing Homes Expert Panel

The Minister for Mental Health and Older People, Mary Butler TD has today published the Third Progress Report on implementation of the recommendations of the COVID-19 Nursing Home Expert Panel.

The COVID-19 Nursing Homes Expert Panel was established as a result of a National Public Health Emergency Team (NPHET) recommendation. In August 2020, the Panel published a report, setting out immediate real-time learnings and recommendations in light of the expected ongoing impact of COVID-19 over the next 12-18 months.

The Third Progress Report highlights the key achievements and progress in implementing these recommendations so far. It also contains the findings of survey responses from service providers on their progress on implementation. The Report highlights that many of the short and medium term recommendations aimed at safeguarding people living in nursing homes against the COVID-19 virus have already been implemented. These include the delivery of a range of supports to nursing homes, including free PPE (Personal Protective Equipment), serial testing, HSE COVID 19 response teams, IPC (Infection Prevention and Control) training and guidance and temporary accommodation for staff.

It also outlines the progress being made in the area of long-term reform of older persons services, including the Safe Staffing Mix Framework in nursing homes, which has 9 pilot sites already selected and due to commence before the end of the year. Other developments include the first National Nursing Home Experience Survey, to be finalised and launched in 2022; the commencement of the phased rollout of the National Patient Advocacy Service in nursing home which began in June; and interim enhancements to the nursing home regulatory framework.

There will be continued focus on the implementation of the Expert Panel report over the next 6 months with a final progress report to be published in early 2022.

Welcoming the publication of the third progress report, Minister Butler said:

Minister Butler continued:

The third progress report is available at: https://www.gov.ie/en/publication/c7f5b-covid-19-nursing-homes-expert-panel-report-implementation-oversight-team/

• in response to the pandemic, as recommended by the National Public Health Emergency Team (NHPET), on 23rd May 2020 the Minister for Health established a COVID-19 Expert Panel on Nursing Homes, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort
• having concluded a significant rapid engagement process with stakeholders across the sector, the Expert Panel’s report was published on 19th August 2020. This comprehensive report included a review and analysis of available epidemiological data, a rapid systematic review of measures to protect older people in nursing homes, and an overview of the international response to COVID-19, along with 86 recommendations, aimed at applying the insights from the Panel’s in-action and after-action reviews within a tight timescale to protect the at risk population in nursing homes over the 18 months from August 2020, and to improve the outcome of the ongoing response to COVID-19 in Irish nursing homes
• the Panel’s recommendations focus on immediate actions required for the response to COVID-19 in the shorter-term and on long-term actions required to affect strategic reform of nursing home systems, operation, policy, and legislation, based on inter alia, the pandemic learning
• the Minister for Health and Minister for Mental Health and Older People established an oversight structure to progress the important recommendations contained in this Report. This encompassed the establishment of both an Implementation Oversight Team (IOT) and a stakeholder Reference Group
• the Implementation Oversight Team, chaired by the Department of Health with membership from across the department, the HSE, HIQA, the NTPF and a public interest representative has now met 16 times since the publication of the Nursing Homes Expert Panel Report. This group continues its work to determine an approach to and oversee the implementation of the relevant COVID-19 Nursing Homes Expert Panel recommendations
• the Reference Group has met 9 times since the publication of the Nursing Homes Expert Panel Report and continues to engage with the Implementation Oversight Team on a range of issues. The Reference Group is also progressing work on the examination of a number of thematic workstreams across the recommendations. The Reference Group has made a significant contribution to the ongoing implementation of the Panel’s recommendations

Key highlights of progress to date

• HSE's COVID-19 Response Teams (CRTs) remain in place and continue to actively support prevention, preparedness, and management of outbreaks. Work is underway to progress the establishment of permanent Community Support Teams based on the learning and key role played by the CRTs throughout the pandemic
• as recommended by the Panel, the public health supports for nursing homes continue to be deployed, including:

o access to supply lines for PPE and medical oxygen including access, free of charge, to PPE on both a precautionary and an outbreak basis

o HSE training and development resources, including the opening of HSELanD to all nursing home providers

o Infection Prevention and Control (IPC) support and advice, including a package of IPC guidance produced and published in March 2020 in addition to then already existing ‘Public Health Guidelines on the Prevention and Management of Influenza Outbreaks in Residential Care Facilities in Ireland 2019/2020’ and the well-established HIQA ‘National Standards for infection prevention and control (IPC) in community services (2018)’

o temporary accommodation to nursing home staff to support measures to block the chain of transmission

o a substantial suite of publicly available guidance, developed to support the sector and updated regularly as new evidence emerges and the epidemiological profile changes

• new visiting guidance, updated regularly by the HPSC. With the benefit of the vaccine programme, regular visiting has now moved away from general and compassionate circumstances only, towards a more normalised situation
• the phased roll out of the Patient Advocacy Service (PAS) to nursing homes has commenced from June 2021, commencing with a roll out to HSE-operated nursing homes over the next 6 months
• an international and national review were undertaken to inform the scope of The National End of Life Survey
• the National Nursing Home Experience Survey is currently under development, with a view to surveying nursing home residents in 2022
• phase 3 (general non-acute care setting) of the Safe Staffing and Skill Mix Framework is underway with piloting of a proposed model commencing in Q4 2021
• recruitment of staff to Public Health roles continues under the Public Health Pandemic Workforce Plan
• completion by HIQA of a voluntary Nursing Home Provider Staff Planning Survey examining the number of staff by Grade, Qualifications and Experience
• completion by HIQA of the Phase 2 voluntary Nursing Home Provider Survey on COVID-19 Preparedness
• publication by HIQA and HPSC of “Analysis of factors associated with outbreaks of SARS-CoV-2 in nursing homes in Ireland” which includes Wave 1 and Wave 2 of the pandemic” and a research protocol for the extension of this analysis to include wave 3
• the established of a Department of Health and HIQA Bilateral Project Group on Regulatory Reform – this group is progressing proposals for interim enhancements to primary and secondary legislation for nursing homes. Following consultation with the Expert Panel implementation structures in Autumn it is intended to progress proposals to Government this year